[Congressional Record Volume 146, Number 88 (Tuesday, July 11, 2000)]
[House]
[Pages H5821-H5827]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HIGH PRICE OF PRESCRIPTION DRUGS PAID BY SENIOR CITIZENS
The SPEAKER pro tempore (Mr. Taylor of North Carolina). Under the
Speaker's announced policy of January 6, 1999, the gentleman from Texas
(Mr. Turner) is recognized for 60 minutes as the designee of the
minority leader.
Mr. TURNER. Mr. Speaker, I yield to the gentleman from Michigan (Mr.
Camp).
Ron Lasch
Mr. CAMP. Mr. Speaker, I want to thank the gentleman from Texas (Mr.
Turner) for yielding to me.
Mr. Speaker, I come to the floor to join my colleagues in recognizing
the long service of Ron Lasch. He has been a very good friend to many
of us in this House, and not just to new Members. I have been here a
number of years and he has been friends and a good advisor to all of
us. I think it is his judgment and friendship that most of us admire
and respect.
As we rush to the floor to cast votes, he was somebody that you could
always go to and count on for the judgment on what was happening on the
floor and the real fine points of debate. But he was also a very good
friend, and he was someone who you could seek advice from and certainly
as a new Member that is important, but it is important every day of the
year around here.
He was also somebody who really new how to keep the confidence but
was not afraid to tell you when you needed some guidance or direction,
and I think it was his plain-spokeness, his directness, his loyalty,
his friendship, his high intellect. I think those are things that
really drew all of us to him.
He will be sorely missed. I hope, in the next few days, we will all
get a chance to talk to him personally and tell him how much we
appreciate this service to this institution, to this House of
Representatives, and I know that many Members on the other side of the
aisle would come and seek his advice as well.
I know he will be missed greatly by all of us, and I just wanted to
go on the record and state what a good friend Ron Lasch has been to me
and to many Members of this House. He will be missed tremendously, and
we wish him all the best in his retirement. And this will be opening a
new chapter in his life, and I think that would be very exciting for
him after 42 years of service to this House, it certainly is well
deserved. I want to join my colleagues in wishing him all the very
best.
Mr. TURNER. Mr. Speaker, I come to the floor tonight during this
special order hour with my colleagues, the gentleman from Arkansas (Mr.
Berry), the gentleman from Texas (Mr. Green), the gentleman from New
Jersey (Mr. Pallone) and other leading Democrats to talk about an issue
that we have worked on for at least 2 years now, and that is the
problem of the high price of prescription drugs being paid by our
senior citizens.
Mr. Speaker, I want to talk a little bit as we begin tonight about
what I believe to be the coming crisis in health care for our senior
citizens.
Just last week, most of us were in our districts over the July 4th
holiday, and we had the chance to talk to our constituents. I had
numerous senior citizens coming up to me and talking about the letter
they had received from their HMO, from their insurance company telling
them that as of the 1st of January, their Medicare choice policy, their
HMO Medicare plan was going to be discontinued by their insurance
company.
In fact, in East Texas, we have almost 5,000 seniors who are
receiving these notices from their insurance companies, companies like
Aetna, NYL Care, Humana are sending out notices to these seniors saying
you are canceled, no longer can you have our Medicare choice HMO
coverage.
Most of these seniors signed up for this option under Medicare,
because an HMO lured them to sign up with the promise of some
prescription drug coverage under Medicare, and these seniors are going
to be greatly disappointed and very upset come January 1 when they find
out no longer do they have access to prescription drug coverage under
their Medicare+Choice program.
A good example of this came in a letter I received just yesterday.
One constituent whose wife's name is Roxanne was dropped from NYL Care.
Here is what this constituent's letter said to me, he wrote, our rights
are being violated by the insurance companies and the politicians who
are on the side of the insurance companies. My wife, Roxanne, he wrote,
will end up in a wheelchair and possibly not able to walk again if
she's denied the drug she needs. How many more Roxannes are out there,
he writes, how many more Roxannes will suffer so the insurance
companies and the politicians can get rich?
Mr. Speaker, well, it is a hard lesson to learn. Unfortunately, our
senior citizens are learning the lesson and that is you just cannot
trust the insurance companies and the HMOs. Our senior citizens are out
there struggling trying to pay the costs of prescription drugs. They
know the insurance companies are not taking care of them, and they know
that the insurance companies simply want to make money, and they are
not interested in what happens to them.
That is why over 5,000 seniors in my district are getting notices as
we speak. When an insurance company decides to pull out of an area, a
lot of people get hurt, a lot of people will be left without coverage
all across this country come January 1.
Some of us here in this House on the Democratic side of the aisle do
care about our senior citizens, the gentleman from New Jersey (Mr.
Pallone), the gentleman from Texas (Mr. Green), the gentleman from
Arkansas (Mr. Berry) and others have been working for almost 2 years
trying to do something about the high cost of prescription drugs.
The sad fact is we know what works, and it is not the insurance
companies' HMO plans. Just 2 weeks ago on the floor of this House, the
Republican leadership passed a plan purportedly to help senior citizens
with their prescription drug costs. It was a plan that said to the big
insurance companies, you all offer insurance plans, prescription drug
plans to our senior citizens and we will subsidize the costs for those
who are at 125 percent of the poverty level and below.
Mr. Speaker, well, for starters we all understand that the problem of
high price of prescription drugs does not just fall on those who are
below the poverty level, it really depends not only what your income
is, it depends on how sick you are.
I have an aunt who is a medical income person. She just got a new
prescription from her doctor for a heart ailment that is going to cost
her $400 a month. She is very upset. She let me know about it. She
wants to know when this Congress is going to act. I told her I hope it
was soon.
The Republican plan that was passed by this House by the narrow
margin of 3 votes was an empty promise to our senior citizens. The
Republican leadership let the private insurance companies control the
prescription drug programs when the private insurance companies
themselves were before this Congress for weeks before that vote telling
us that they will not offer any prescription-only drug plans.
What really happened on the floor of this House is the big
pharmaceutical manufacturers carried the day. After all, they had been
running ads for weeks under a front group called Citizens for a Better
Medicare, advertising
[[Page H5822]]
full page ads in the newspapers and ads on the television screens that
said the answer to the problem of prescription drug coverage for our
seniors is private insurance, private insurance, private insurance, and
sure enough that is what the Republican leadership did, pass a plan
saying that private insurance was going to solve the problem.
Mr. Speaker, well, we on the Democratic side of the aisle know that
it is not going to solve the problem. In fact, even the insurance
company knows that it is not going to solve the problem.
Listen to what the President of Blue Cross-Blue Shield had to say
about the idea of prescription drug-only insurance policies for
seniors. He testified it, referring to the prescription drug plan that
was proposed by the Republican leadership, it provides false hope to
America's seniors because it is neither workable nor affordable. That
is what the insurance industry said about the plan that they are
supposed to offer under the Republican bill.
The truth is, the Republican plan that was passed on this House floor
by a margin of three votes is no plan at all. It might have made a nice
press release over the July 4th holiday, but that is all it was, a
press release. It is really interesting because my senior citizens in
my district have already figured it out, and they were coming up to me
over the July 4th holiday saying we know that bill that passed is never
going to amount to anything for us.
The New York Times had an article in this weekend's paper about
insurance companies rejecting the same proposal that we just passed
that was passed a few months ago by the legislature in Nevada. The New
York Times wrote about the insurance company spurning Nevada's
invitation to provide coverage of prescription drug-only policies for
their seniors.
{time} 1845
When they advertised for bids by insurance companies under the
legislation they passed, not one single insurance company was
interested in the plan. The idea just does not work. It is just kind of
like offering insurance for haircuts. It does not work because
everybody needs one. Insurance companies understand that. It is not
something that one insures.
Most all of our senior citizens need coverage for prescription drugs.
That is why the insurance companies cannot offer one that is
affordable. Frankly, it is an idea that simply will not work.
Unfortunately, the Republican leadership in the House did not
understand that.
So what does work? What does work is what the Democrats in this House
proposed and were not even given the opportunity to present it on the
floor and debate it, and that is to provide a prescription drug benefit
under the Medicare program, a program that seniors have trusted since
1965 to help them cover the cost of their health care.
Our plan was affordable. It was voluntary. It was universal. It
covered all people regardless of their income level. That is what our
senior citizens deserve. I hope that when we celebrate the 35th
anniversary of Medicare at the end of this month, we will be able to
say that this Congress has acted responsibly and passed a real plan to
help our senior citizens with their prescription drug costs.
It is time that we take that long-needed action. If Medicare were
created today, there is no question we would have a prescription drug
coverage. Back in 1965, only about 10 percent of our health care cost
was taken up by purchase of prescription drugs. Today they tell us it
is about 30 percent.
The truth is prescription drugs have done a lot of good things for
us, but what good is the cure if one cannot afford the medicine? That
is what my seniors are telling me, and they are right.
Citizens For Better Medicare advocated the plan that was passed. The
big pharmaceuticals carried today. But our senior citizens today were
big losers. I think it is time for us to stand up for our seniors and
let the folks in this Congress who were on the side of the big
pharmaceutical manufacturers understand that our senior citizens want
better treatment than that.
After all, why should we give billions of dollars of taxpayers' money
to insurance companies and big HMOs when they do not even want to offer
those plans? Let us give the money back to our seniors in the form of
lower drug prices, then we will have done something that helps those
senior citizens.
I am very pleased tonight to be joined by the gentleman from Arkansas
(Mr. Berry). He serves along with the gentleman from Maine (Mr. Allen)
and I on the Prescription Drug Task Force. We have worked for almost 2
years to try to bring some relief to senior citizens.
Mr. Speaker, I am pleased to yield to the gentleman from Arkansas
(Mr. Berry) and allow him to share his thoughts on this very important
issue.
Mr. BERRY. Mr. Speaker, I thank the distinguished gentleman from east
Texas (Mr. Turner). It has been a pleasure to work with him all these
years that we have worked on this issue. When we started, we did not
think it would take this long, did we? But it has been amazing that it
has been this difficult to get the right thing done.
I also appreciate the gentleman from New Jersey (Mr. Pallone) and the
gentleman from Texas (Mr. Green) for being here this evening and
continuing to work on this issue.
As the gentleman from Texas (Mr. Turner) spoke a few minutes ago so
eloquently about this problem and about this scheme that the
Republicans cooked up to try to make senior citizens think they cared,
I was reminded of a story they tell in my part of the country about the
fellow that raffled off a dead mule. The only people that got mad or
the only person that got mad about that was the fellow that won it.
That is the way our senior citizens are going to be if we would be so
unfortunate as to have this Republican scheme ever become law. They
would be mad about it because they would find out that what they had
was something worthless, a dead mule.
It is very disturbing to think that something like that could happen
on the floor of this House. I do not think it will ever become law. But
certainly we are going to do everything we can to prevent that from
happening.
When Lyndon Johnson 35 years ago signed into law the Medicare bill,
it was a great success. It has been a wonderful thing for our senior
citizens. We had many senior citizens at that time that had no health
care coverage. They just had to do without. When they got sick, they
just got sick. They could not afford any health care. They did not get
any. That is a shameful thing to allow to happen.
When President Johnson signed that bill into law, he made this
comment, that we should never ignore those who suffer untended in a
land bursting with abundance. I think that is a very powerful
statement. I think he was sending a message to us today when he said
that.
Prescription drugs are the basis of medical care for our senior
citizens now. In the district that I am fortunate to represent, we have
a large number of senior citizens that live only on Social Security.
They do not have any retirement plans. They do not have any other
income. Most of them have been able to provide for a decent place to
live. They have a homestead.
They are able to make it just fine on their Social Security until
they get sick and they have to start taking expensive prescription
drugs, drugs that one can buy all over the rest of the world for a lot
less money than what one can buy in the United States. This is a very
disturbing thing that we have allowed the drug medicine makers in this
country to take advantage of our senior citizens in such a way.
We have simply allowed these prescription drug makers to rob our
senior citizens and throw them into abject poverty in many cases.
Our Founding Fathers, the last sentence of the Declaration of
Independence, before they signed it, and many of those men thought they
were signing their own death warrant, they said ``in support of this
declaration, we pledge our lives, our fortunes, and our sacred honor.''
I think that, too, is a powerful statement. It led to this great
Nation.
But as we have worked on this issue and done everything we know to do
to get a good vote, to get this issue to the floor and get a good clean
vote on it and do the right thing, I have thought many times what these
Founding Fathers would think about this great Nation that they founded
and this great
[[Page H5823]]
House of Representatives and this great Congress that they envisioned
allowing this to continue to go on.
I have just got to believe that they would be ashamed of us. I have
got to believe that if they were here tonight, they would keep us here
day or night until we did something about this because it is an outrage
that we continue to let the prescription medicine makers in this
country rob the American people.
I think they would say, what is going on here? Why are you doing
this? We talk about it on the floor as if it was a political issue.
These are real people. They suffer real pain. It is not politics with
the people that are affected, and we should realize that.
The prescription drug manufacturers in this country have hired some
300 lobbyists, that is over one lobbyist for every two Members of this
House of Representatives, to do everything they can to not change their
deal. They think they have got a great deal, and they want to keep it
that way. The best information that we have is they will still make
lots and lots of money. They will still be the most profitable
businesses in this country.
But we have got to, as a Nation and as a Congress, allow our
Americans to buy these medicines at the same prices that all the other
countries get to buy them at. That is not fair to let everyone else get
a much better deal than we do.
A few weeks ago, I was privileged to be on a mission to Cuba. As we
visited with the representatives of the Cuban government about buying
our food, about buying our agriculture products, and they were excited
about that and they wanted to do that, and part of the discussion was
food and medicine. We said, Well, you have expressed your desire to buy
food. What about our medicine? They said, Oh, we do not want to buy
your medicine. We can buy your medicine a lot cheaper than you can. We
can buy it from Canada. We can buy it from Panama. We can buy it from
Mexico. We can buy it from a lot of places a lot cheaper than you can.
Then they said something that made it really come home to me. They
said, Why do you do that to your people? Why do you allow that to go
on? Why do you allow these companies to rob your people? That is not
right. They were absolutely right about that. I will never forget that
moment when that was pointed out to us in a very powerful way.
We need a prescription drug medicine benefit for Medicare. We need to
modernize Medicare and make it a great program that we know it can be
and should be. To think that we are going to give the taxpayers' money
to the insurance companies in the hopes that they would try to solve
this problem when they have told us themselves we do not want any part
of it, the gentleman from Texas (Mr. Turner) mentioned this, it is like
selling insurance for haircuts.
I have also heard it compared to selling insurance on the house one
knows is going to burn down. Senior citizens are going to get sick.
They are going to have to take medicines. That is the reason why this
needs to be a Medicare benefit and not some insurance scheme that we
have already found out over and over and over again it just does not
work, as the gentleman has pointed out.
The HMO providers in Medicare are pulling out all over the country
because it just simply does not work for them, and that is fine. But we
have to recognize as a Nation if we are the great neighbors that we
claim to be, we must take care of this problem, we must see that our
seniors do not get robbed by the prescription makers in this country,
and we have got to take care of this terrible situation that has been
created.
Mr. TURNER. Mr. Speaker, I thank the gentleman from Arkansas (Mr.
Berry) for his telling comments, particularly about his visit to Cuba.
Even the Cubans understand that our senior citizens are getting ripped
off and everybody in the world gets a better deal on prescription drugs
than we do. That is really telling. I compliment the gentleman on his
remarks.
I also want to mention the gentleman from Arkansas has been a leader,
not only in our Prescription Drug Task Force, but in his sponsorship of
the legislation that would allow senior citizens of this country, and
all of us, to be able to buy drugs in Mexico or Canada, and we can do
that legally. Obviously that is where we would all buy them because
they get them for less than half the price that we are having to pay
for them.
Mr. Speaker, I yield to the gentleman from Texas (Mr. Green). The
gentleman from Texas and I served, not only here together, but in the
State senate before. He is a leader on the Committee on Commerce on
this issue, and he has worked long and hard to try to bring some
fairness to prescription drug prices and to provide some benefit for
our senior citizens of this area of great need.
Mr. GREEN of Texas. Mr. Speaker, I want to thank the gentleman from
Texas (Mr. Turner), my good friend and former Texas State
representative, and I served with the gentleman from Texas (Mr.
Turner), Texas State senator, former mayor, and now Member of Congress,
for putting together this Special Order tonight.
This is not a national security issue where everybody is only going
to have to listen to folks from our part of the country tonight. We
have the gentlewoman from Connecticut (Ms. DeLauro) and also the
gentleman from New Jersey (Mr. Pallone), so they will not have to hear
Texas and Arkansas accents all this evening on this important issue.
But it is a national issue. I know people just like to hear us because
we talk a little slower. But no matter how we talk, I think we are
united on this one issue because we know that, from Texas, we call it
buying a pig in a poke.
I think what the House passed the week before the 4th of July was a
travesty. It was something that the seniors can see through, and we
said that on the floor. That is why I think it only passed by three
votes as the gentleman from Texas said.
I am glad we are using this time to continue to explain the fallacy
of that bill that was passed, that our Republicans colleagues had
succeeded in passing a prescription drug benefit that provides more
political cover than it provides for prescription coverage for our
Nation's seniors. The legislation was designed to benefit the companies
who make the prescription drugs and not necessarily our seniors.
Just like the Patients' Bill of Rights and education funding, my
colleagues on the other side of the aisle are using their same old
strategy. They water down legislation. They pass a caption that sounds
good, but it does not have any benefit to our folks. Ultimately, it
will be a failure because all they want to do is get them past the
November election.
Congress, our own budget office, concluded that more than half of our
Medicare beneficiaries who do not have drug coverage today would not be
covered by the Republican private insurance plan. I cannot stress that
too much. It is an insurance plan.
Like the gentleman from Texas said, it is like buying insurance
against haircuts. Everyone of us needs one, although I have to admit
some of us do not need as many as we did a few years ago, but we still
get them even though we do not need them as much.
What is more frustrating is we did not even get the chance to offer
an alternative plan. Again, not only is their plan bad, but they were
so afraid to defend it that they thought maybe an alternative plan, and
again we have a Democratic plan I will talk about in a minute, but any
alternative they did not even want to have a vote on.
{time} 1900
So not only do they pass a bill that I think is hurting seniors, but
they are even subverting our process here in the House. All of us ought
to have an opportunity to give choices.
In fact, it is interesting, I believe in free enterprise, just like
my colleagues on the other side of the aisle, but I believe in
competition. On the prescription drug benefit they did not want to have
competition on their bill because it could not hold water to the
alternative plan we had. The Democratic proposal provided both a
universal and voluntary benefit to seniors. It was a cost effective and
reliable benefit.
Under the Democratic plan premiums would be lower for seniors and
coverage would be higher. That is why they did not want that
competition they are always talking about. Instead, the House
[[Page H5824]]
of Representatives, by three votes, as the gentleman said, passed a
flawed piece of legislation that will cost our seniors more each year
and give them less. Some say the premiums could even double because it
is a straight subsidy to the insurance industry who know that they
cannot make money selling it, and it would be little benefit to our
middle income seniors, seniors who just barely are above the poverty
line and cannot afford the prescriptions that they have now.
It allows insurance companies to decide which drugs they would cover
and how much they would charge. It would not be a guaranteed benefit
and it would not be any standard benefit that our seniors could depend
on. So our seniors would have to go back to their insurance company
every time.
I have talked to lots of seniors over the last couple of years about
this issue and they really want their prescriptions. They do not want
an insurance policy. That is the frustration. I have met with seniors
in my district, like the gentleman has in his district, and they have
serious financial hardships due to the high cost of prescription drugs.
They have been able to plan, as best they can, for their retirement,
with Social Security as probably the biggest part of their income. They
may have a little savings, a little pension, but they cannot afford
$400 or $500 prescription medications. They have shown me their
prescription drug bills at our town hall meetings, and I do not see how
they survive.
These seniors have to choose between paying their bills, their
utilities in the summer, and in Texas you cannot turn off the air
conditioner or you will die of heat stroke. Just like those in the
north, in the winter, would die of freezing. We do not want seniors to
have to choose between turning off their air-conditioning or buying
their prescriptions, or saying they will only take that blood pressure
medicine every other day instead of every day, or even skimping on the
food that they eat.
I know I will be meeting with these seniors again and again over the
next few months, and it is frustrating because I will have to tell
them, yes, they may have a benefit, but only if their insurance company
decides they can have it. Again, it is going to depend on the insurance
company. We should be putting benefits in the hands of senior citizens
and not the pharmaceutical manufacturers. We should be providing a
secure and stable and reliable benefit instead of creating a new
bureaucratic nightmare.
The Republican plan created a new Federal bureaucracy. Not only
insurance but it created a new Federal bureaucracy. Instead of using
the current bureaucracy that we want to make more cost effective, we
should be building up Medicare instead of tearing it down. Seniors
deserve more than just a voucher. They need to have a real workable
prescription drug benefit plan.
I hope this Congress ultimately will work across party lines and
develop a bipartisan bill. We could not do it in the House. Maybe the
U.S. Senate will take the leadership and provide a bill similar to the
bill that we tried to offer. In the Senate they have more democratic
rules than we do here in the House. That is with a little ``d'' not
partisan ``d.'' Hopefully, the Senate will allow an alternative plan
and it will have a meaningful Medicare prescription drug benefit for
all our seniors.
Again, I could stand here all night, but we have our colleagues from
New Jersey and from Connecticut here. Again, I appreciate the
gentleman's leadership on providing this special order tonight. We need
to keep beating that drum, because, frankly, that bill would not have
been on the floor 2 weeks ago if it had not been for us talking about
it over the last 2 years. We need to keep that up, because not only do
we need the bill on the floor but we need real legislation that will
help our seniors. I thank the gentleman for this time tonight.
Mr. TURNER. Mr. Speaker, I thank the gentleman from Texas. I share
the gentleman's sentiments. I really do hope that we can get a plan
that is meaningful passed in this session of the Congress. There is no
reason we cannot.
I think what we went through the week before last on this floor was
disappointing to all of us, seeing that Republican plan pushed through
without any option to even debate our plan of putting it as a benefit
under Medicare. It was a disappointment I think to all of us.
I know there is not much time left. And if this Congress wants to
avoid the label of a ``do-nothing Congress,'' it needs to take some
action on prescription drugs for our seniors. It is amazing. Before
that bill passed on the floor of this House 2 weeks ago, the President
said he was going to veto it. The time was to stop right there, get
together, try to work together and work something out. People of this
country are tired of this partisan approach to dealing with these
issues. They want to see some real solutions and they expect us to get
together and do that.
So I thank the gentleman for sharing his thoughts with us tonight.
The next speaker this evening is a gentleman who has probably been on
this floor in the late evenings more than any other Member of this
House, the gentleman from New Jersey (Mr. Pallone). He believes
passionately in the problems faced by our seniors, and he has been on
this floor tirelessly working on their behalf.
It is a pleasure to yield to one of the leading spokesmen on behalf
of our seniors on this issue, the gentleman from New Jersey (Mr.
Pallone).
Mr. PALLONE. I thank the gentleman from Texas. And contrary to what
the gentleman from Texas (Mr. Green) said, I think he said we enjoyed
listening to the two Congressmen from Texas and the gentleman from
Arkansas, and that is true, but I think more importantly than the way
the gentlemen spoke, it is what you were saying. Because substantively
I think that the gentlemen are really speaking about what the truth is.
One of the concerns that I have during this whole debate that we went
through a couple of weeks ago on Medicare and on the issue of
prescription drugs is that the Republicans are trying to disguise what
their intentions are with regard to a prescription drug plan. All they
are really doing, as some of my colleagues have pointed out tonight, is
trying to say to our senior citizens that they should go out and try to
see if an insurance company will sell them a prescription drug-only
plan. And if they will, fine; and if they will not, tough luck.
As the gentleman mentioned, so many of the insurance companies and
their lobbyists have come into Congress before our congressional
committees, before the Committee on Commerce that I serve on, and said
that they are not going to sell those policies. The example the
gentleman mentioned about the State of Nevada, which passed, I guess
about 3 or 4 months ago, something very similar to the Republican
proposal, is that the insurance companies simply will not sell these
policies. That is why it is not working in Nevada and that is why it
will never work here, even if the bill ultimately passes, which is not
what I think the Republicans intend.
I wanted to state very simply from my perspective the reason why the
Democrats tried to put forward a real Medicare drug benefit. Basically,
what the Democrats were saying is that Medicare has worked. It was
passed back in the 1960s by a Democratic Congress. Lyndon Johnson was
the President then. And if we think of it from the point of view of the
average senior, it makes sense. Right now they know that under part A
of Medicare their hospitalization is covered. They know that if they
voluntarily decide, which most people do, to opt for part B, which
covers their doctors' care, that they pay a certain amount of premium
per month and their doctors' bills are basically covered with some kind
of a copayment.
Now, what the Democrats are saying is we want to establish another
part of Medicare, part C or D or whatever we want to call it, that
covers prescription drugs. And just like part B that covers the
doctors' bills, if an individual pays so much a month, an honest
premium, then that individual will have most or a significant part of
their prescription drug benefit paid for through Medicare. We are
simply building on the existing Medicare program that has worked for
the last 30 to 35 years, and we want to expand it now to cover
prescription drugs. That makes perfect sense.
Why go through all these hoops and bureaucratic niceties to say,
okay, we
[[Page H5825]]
will try to get the insurance companies to sell a drug-only policy,
which they do not want to sell anyway, when we could simply expand
Medicare to prescription drugs in the logical way we have included part
B for doctors' bills now?
The Democrats are also saying that the Medicare benefit provides the
guarantee that individuals will have and will be able to obtain any
prescription drugs that are medically necessary. The key again is
medically necessary. If the doctor says that an individual needs that
prescription, that that particular drug is needed, then it would be
covered under the Democrats Medicare plan.
The Republicans not only are telling seniors that their option is to
go out and try to get somebody who will sell them an insurance policy,
but they are also not saying what that insurance policy has to be, even
if they could buy it, which they cannot. They are not telling seniors
how much the premium would be, they are not telling the elderly or the
disabled what kind of drugs the insurance company would cover.
Basically, that is up to the insurance company to decide. Why, again,
are we reinventing the wheel when we know we have an existing Medicare
program that works and could be simply expanded to include prescription
drugs?
The other thing I wanted to mention tonight, and I think is just as
important, is that the Republican plan leaves American seniors open to
continued price discrimination. The gentleman from Texas (Mr. Turner)
said that as well. There is nothing in the Republican bill to prevent
the drug companies from charging whatever they want.
Now, what we said in our Medicare bill is by expanding Medicare to
include prescription drugs, we will have the government basically
choose a benefit provider in each region that will negotiate the best
price. All these Medicare recipients, all these seniors, are now going
to be in one program. I think there is something like 30 to 40 million
Americans that would be eligible under this program. If these benefit
providers are out there negotiating for a better price because they
have all these seniors, they can get a significant discount. I do not
know whether it will be 10 percent, 20 percent, or whatever it will be,
but they will get a significant discount. So at least we are trying
through our Democratic proposal to address the price discrimination
issue. The Republicans are not even dealing with that.
I just wanted to mention two things, and I think the gentleman
actually already mentioned it, about this article that was in The New
York Times on Saturday regarding the Nevada experience. I do not think
I have ever seen an article where they compare what was being done in
the States as compared to what is being done in the Federal Government.
We usually pride ourselves in the fact that the States sort of serve as
the laboratories and do things, and if they work out well then we adopt
them at the Federal level. We did that in the gentleman's State of
Texas with the Patients' Bill of Rights. Basically, the Federal bill
that the Democrats have been pushing is very similar to what the
gentleman has in his State on HMO reform.
Here we have a situation in Nevada where they adopt a drug plan, and
then what do the Republicans do in the House of Representatives? They
copy the example, which is failing. Not the example that worked, like
in Texas with the HMO reform, but the example in Nevada, which is
failing; where they cannot get any insurance company to provide an
insurance policy, and they adopt it here and say this is going to work.
I do not like to quote from newspaper articles, but I just cannot
help lift a few things from this New York Times article because it is
so much on point in basically explaining how the Nevada plan is exactly
the same as what the Republicans have proposed here in the Congress. If
I could just go through a couple of things here.
It says, ``Nevada has adopted a prescription drug program for the
elderly very similar to one approved last month by the Republicans in
the House of Representatives, but it is off to a rocky start. Insurance
companies have spurned Nevada's invitation to provide coverage. The
risks and the costs are too high, they say, and the subsidies offered
by the State are too low. Nevada's experience offers ominous lessons
for Congress, especially Republicans, who want to subsidize insurance
companies to entice them into providing drug benefits to elderly and
disabled people on Medicare.''
They go into how in March, as I mentioned and the gentleman
previously mentioned, this was adopted. And I guess they have a task
force, the way I understand it. There is a task force set up within the
Nevada legislature that basically monitors the use of the money and
decides whether or not, if an insurance company applies to sell these
policies, that they would pass muster under the Nevada legislation.
Apparently there was only one insurance company that was even
interested, and they actually were disqualified under Nevada law.
The assemblywoman, and it does not say what party she is on, but who
was the cochairman of this task force monitoring the use of the money
says, and I quote, ``I have my doubts that any insurance company will
be able to offer meaningful drug benefits under this program. If an
insurance company does bid on it, but the benefits are paltry, senior
citizens will be up in arms.''
And then it goes on to say how even in Nevada the insurance companies
came to the State legislature, just like we had the lobbyists from the
insurance companies here in Washington, came to the legislature and
said they did not want to sell these policies, and they passed the bill
anyway. We have the same thing here. We had, as mentioned again in the
article, the Health Insurance Association of America, which is the
trade association for the health insurance industry, they came before
the Committee on Commerce and they told us that they did not want to
sell the policies. And they have a quote in here from the Health
Insurance Association of America saying they are not interested in
selling drug-only insurance to the elderly.
{time} 1915
I do not know how more clear it could be when the insurance companies
tell you they are not interested, they are not going to sell these
policies.
I do not want to keep reading from this article, but it is amazing to
me that so many times, and I was in the State legislature in New
Jersey, how you pass something in the legislature and it works and then
you come down here and you say, ``That's a good idea, let's adopt it
nationally.'' Why in the world would the Republicans use a bad proposal
that nobody wants to use and come here and say this is what we should
adopt as the national example?
The other thing I wanted to mention, because I did get into the issue
of cost, is that the cost of prescription drugs continues to rise.
There are so many examples over the last 6 months or the last 6 weeks
about the increased costs. There was a survey that was done just before
we left, I guess it was actually the week we were here voting on the
prescription drug program, and this is again in the New York Times, it
was a study released by Express Scripts of St. Louis on June 26. It
said spending on prescription drugs increased a record 17.4 percent
last year and elderly people experienced the largest cost increases.
This was about the same time that we voted on it. It said that the
statistics show why elderly people feel a pressing need for the
coverage and why many Members of Congress are worried about the costs.
Spending on prescription drugs averaged $387 a person last year, up
17.4 percent from the average the year before. But for seniors, the
cost rose even more. In 1 year, a 17 percent increase.
Where are we going with this? We have to do something about it. We
have to provide comprehensive coverage under Medicare and we have to
address the price discrimination issue as well. The gentleman has been
doing such a great job this evening and at other times in bringing this
to the attention of our constituents.
Mr. TURNER. Mr. Speaker, I thank the gentleman from New Jersey (Mr.
Pallone). I really appreciate his remarks. I am glad he brought this
New York Times article to our attention. I read it myself. Sometimes
things are so unbelievable that you have to say them two or three times
before it really sinks in. I am a pretty trusting person, but the truth
is the Congress did
[[Page H5826]]
exactly what the State legislature in Nevada did that had been proven
through their experience was not going to work. And the same insurance
company executives, the same insurance companies that testified before
our committees and told our Congress that the Republican plan was not
going to work told the Nevada folks that their plan was not going to
work. They went ahead and did it, anyway, and then they advertised for
bids, according to the article, and nobody wanted to apply. Nobody
wanted to offer this prescription drug coverage by private insurance
companies. It is just almost incomprehensible that the Congress of the
United States would propose the same plan with the same insurance
companies saying we are not going to offer it and it would pass this
House. It did not pass with my vote or your vote or the vote of the
gentlewoman from Connecticut (Ms. DeLauro), the gentleman from Texas
(Mr. Green), or the gentleman from Arkansas (Mr. Berry). Our Democratic
side of the aisle was united in opposition. But the truth is some
things are almost beyond belief.
I really was proud of our colleague the gentlewoman from Nevada (Ms.
Berkley), who is a good Democrat representing Las Vegas when she stood
up, and she was quoted in this same article, saying she did not
understand why Congress would try to copy a troubled State program from
her State, and I want to read her quote from this article because I was
so proud of her standing up on behalf of our seniors, taking on the
Governor of Nevada and she said this: Why in the world when it is not
yet functioning for low-income seniors in Nevada would we try to
replicate it for the millions of seniors who are desperately in need of
affordable prescription medications? It took a lot of courage. I admire
her for standing up for seniors in spite of the fact that her own
Governor still says, well, he thinks somehow it is going work, even
though there is no insurance company stepping forward to offer the
plan.
Our next colleague to share with us is the gentlewoman from
Connecticut (Ms. DeLauro). There is not a more passionate voice in this
Congress on behalf of senior citizens than the gentlewoman from
Connecticut. She is assistant to the leader. She works day after day
tirelessly on this and many other issues of importance to the people of
this country. It is a pleasure to yield to her on this very important
issue.
Ms. DeLAURO. I thank my colleague from Texas so much for his kind
words and for organizing this effort, and along with my colleague from
New Jersey of really being the leaders in this effort of trying to
genuinely craft a piece of legislation that addresses what the crying
need in the country is on some relief from the cost of prescription
drugs. I would like to just say that that is what to me is what the
contrast is. I know folks will say, well, you know, you are being
partisan about this, but I think if you take a look and you listen to
where my colleague the gentleman from Texas (Mr. Turner) has been these
last 18 months and the gentleman from Arkansas (Mr. Berry) and the
gentleman from Texas (Mr. Green) and the gentleman from New Jersey (Mr.
Pallone) and others, they have been a consistent voice for trying to
bring some sense to this issue of the rising cost of prescription drugs
and the fact that senior citizens are making decisions about whether
they pay their rent or buy their food or buy their medication. That has
not been in the last 2 weeks, not in the last month but over the life
of this Congress. They have been out there day after day after day
trying to do something about this. This is where I think the public
gets this. I think the public really understands this. We found a
matter of about a month ago that a report was written to our Republican
colleagues by some folks in an organization called Public Opinion
Strategies, and the report to our Republican colleagues was, ``You guys
better address the issue of prescription drugs because it's a serious
issue, and you need to show the public that you care. It doesn't make
any difference whether you really care but let them know that you care.
And that you better talk about a plan even if you don't have a plan,
because it's important.''
We did not need someone from Public Opinion Strategies or anywhere
else to tell us about the serious plight of people in this country and
particularly seniors around the cost of prescription drugs. Nobody had
to force that mantra on us if you stand the way you do with your
constituents and your meeting with them and talking to them. I do
office hours at Stop N Shops, large grocery stores, every week. If you
are out there the way that you have been and you are listening to what
people are talking to you about, you do not need someone from Public
Opinion Strategies telling you to scramble around, put together
something so that you can say that you care about an issue when there
are folks like yourselves who have been on this floor day in and day
out for the last 2 years, almost 2 years, talking about this issue.
If you took a look at the newspapers or the TV news a couple of weeks
ago, you might have thought that this Congress actually did something
to help seniors with the crushing cost of prescription drugs. There
were our colleagues on the other side of the aisle running around,
slapping each other on the back, holding press conferences and taking
credit for helping seniors with prescription drug costs. But, sadly,
that activity 2 weeks ago had more to do with the press conferences and
the taking of credit rather than passing some real Medicare
prescription drug benefit that people so desperately need. Quite
frankly what happened here 2 weeks ago was a sham. That was because a
Republican pollster and a handler told them that if they did not look
like they were at least doing something, that they were going to pay a
price in the fall elections. But the public is savvy and the public is
smart.
What is interesting to me is that at the very time when our
colleagues on the other side of the aisle designed a program that was
going to be run through the private insurance companies or through the
HMOs, and as you both have said so eloquently, people who came up here
to testify from the industry said, ``We don't want any part of this.
This is doomed to failure. We don't want to take on the risk.'' At that
very same time, though you would think that the private insurance
companies and the HMOs would be trying to at least curry some favor
with the public or to at least give an impression of their wanting to
do what insurance companies have been in the business of trying to do,
and that is to share risk, that is what insurance is about, they then
announced the first part of July that, wow, we are going to pull the
rug out from under seniors by jumping out of the Medicare Choice Plus,
that HMOs were going to get out of the Medicare business.
In my State of Connecticut, 52,000 people are now going to scramble
to figure out what they do about their insurance coverage. If you want
to add insult to injury, we have got a group of folks here who say,
whoa, let's entrust the prescription drug benefit through these
entities that if their bottom line is less than the profit margin that
they want to make, not that they are not making a profit, but it is
less than what they want to make, they vamoose, they go away and say,
``You're on your own.'' It really is mind-boggling that they would in
the midst of this incredibly important conversation about trying to
provide a benefit. It just says to me loud and clear that they are not
interested. They are not interested in providing a benefit because they
do not want to take on the risk, and they are not interested in
providing health care coverage if it does not meet that profit level
that they anticipate to make.
I met yesterday in two meetings with close to 350 seniors. I did that
and brought in some folks to talk to them because the HMO coverage does
not end until December 31, so that they have got some time. I wanted to
try to reassure the seniors in my community not to panic because we are
going to try to get some answers, try to get them some information
where they can go back to the original Medicare, they can get a MediGap
supplement and so forth, so that they should not feel that they had to
jump before they had any understanding about what premiums were going
to be, what benefits were going to be, et cetera.
One wonderful woman, she just darted up, and she said,
``Congresswoman DeLauro, I know you're telling us not to panic, but we
are in a panic. We are. We don't know what we're going to do. We don't
know if we're going to get coverage. We don't know if our benefits
[[Page H5827]]
are going to be cut. We bargained for this. What is going to happen to
my prescription drugs?'' I am standing there saying to this woman not
to panic, but they have every reason to be concerned. I am still going
to reiterate not to panic because we want to try to see what we can do,
but people are very concerned, and that is compounded because they
joined these programs, many of them, because it held out a prescription
drug benefit.
One woman in another meeting got up and she said, ``They wined and
dined us. They met with us. They took us out for lobster dinners. They
talked with us about this and then they pulled back. And this is just 3
years ago. They have now pulled back.'' Lots of those folks joined up
because it was a prescription drug benefit because they are being
choked to death by the cost of prescription drugs.
To just enforce what you have said and to associate myself with you,
that on this floor we could see that they produced a plan on the other
side of the aisle that put the fate of our seniors in the hands of
these institutions who will not wait around to see whether or not
something works and that provides a benefit to seniors. But again if
the profit motive is not there, they are gone.
{time} 1930
And they are gone in a heartbeat. That says something loud and clear
to me about the values of those institutions, as well as the values of
the people in this House who decided that that was the way in which we
ought to deal with prescription drugs in our society today, because
that is what this issue bears on, is the issue of values, what we
believe are the priorities and what are the things that are important.
When you get to looking at budgets, they are living documents. They
are living documents. It is about who we are as a country. And we have
laid out a prescription drug plan as Democrats that I am proud of. I
really am proud to stand behind this. It says, Let's go through a
system that we know has made one incredible difference in the health
care of seniors in this country. Ninety-nine percent today of our
seniors are covered by Medicare, and it may have its warts and it may
have some difficulties, but it has worked. It is tried, it is true, it
is reliable, it is trustworthy, and seniors have come to count on it.
Let us work through something that has roots and that people do
understand and trust and says it is defined for you, it is voluntary,
it covers all of the seniors, everywhere in the country, and it will
make a difference in driving that price down, and it will bring you
some relief, so that while you are ill, you know you can get and pay
for the medication that will help to make sure that you are healthy and
that you are safe.
I am proud to be here with my colleagues tonight to talk about it,
and I know we will every single night, talk about this issue which
plays such an enormous role in the lives of families today.
Mr. TURNER. Mr. Speaker, I thank the gentlewoman from Connecticut
(Ms. DeLauro) for sharing her thoughts on this issue. You talk about
those seniors that you visited with over the July 4th recess, and I
always come back to a lady that is my constituent down in Orange,
Texas, that came into a little gathering that I had over 2 years ago at
a local pharmacy there in Orange in Southeast Texas, when I went around
for the very first time in my district to talk about the problem of the
high price of prescription drugs and what I thought we should try to do
about it in Congress.
She heard I was coming by a little newspaper article, and she showed
up, a lovely lady, Mrs. Francis Staley, 84 years old, blind. She takes
12 prescriptions. They cost her about what her Social Security check
is, $400-some a month, and she just came by to tell me that she
appreciated that we were trying to help.
Now, there are a lot of Ms. Staleys out there, and there are going to
be a lot more, as the gentlewoman from Connecticut (Ms. DeLauro) said,
when these seniors start getting the notices that most of them are
getting in my district and yours and that of the gentleman from New
Jersey (Mr. Pallone), saying that their Medicare+Choice plans are being
cancelled by their insurance company.
As was said, most of the seniors that signed up for those plans did
so because they wanted the prescription drug coverage that those
insurance companies used to entice them to sign up in the first place.
We are truly headed for a crisis in health care in this country,
specifically a crisis relating to prescription drugs, because you must
know that the people that signed up for those Medicare+Choice plans
were the very seniors who really needed the prescription drug coverage.
Now, our country is very prosperous. We live in better economic times
than we have ever known. We have had record surpluses reported to this
Congress, and, if we are the compassionate people that I hope we are,
we can see our way clear to pass a meaningful, genuine prescription
drug benefit under the Medicare program for our seniors. I truly
believe we can.
____________________